Many anti-inflammatory medications are available over the counter, typically in the pain relief section of the pharmacy. Anti-inflammatories help relieve pain and discomfort due to inflammation.
Anti-inflammatories are often known as nonsteroidal anti-inflammatory drugs (NSAIDs).
Most people will experience no ill effects from using NSAIDs for minor aches and pains. However, certain people — such as those with high blood pressure — should talk to their doctor before taking an NSAID, as they may not be safe to use in this case.
All OTC anti-inflammatories share some common elements. For example, they all block prostaglandins. Prostaglandins are largely responsible for stimulating the nerve endings and causing pain when an area is inflamed.
A person can use OTC anti-inflammatories to treat a variety of conditions and complaints, including:
- muscle aches
- aches and pains associated with menstruation
- sprains and other minor injuries
- the symptoms of arthritis and other inflammatory conditions
- pain following surgery
Aspirin helps treat inflammation and related pain. Some people also take it to prevent heart attacks.
People taking any medications for gout, diabetes, a heart condition, or arthritis should talk to their doctor before taking aspirin.
Pregnant women, people with heart disease, those taking steroids, and those taking antidepressants should also contact a doctor before taking aspirin. People who are allergic to aspirin may also wish to avoid it.
People should always follow the dosage guide on the packaging. Aspirin is available in several different sizes and types. If a person is not sure how much aspirin they should take, they can talk to their healthcare provider. They should discontinue use if they notice any side effects.
Below are some tips from the United States National Library of Medicine for taking aspirin:
- Drink a full glass of water with each dose. Sometimes, taking aspirin with food or milk can help decrease stomach upset.
- Children under 12 years should not use aspirin unless a doctor approves it.
- Adults and children over 12 years can take one or two 325 milligram (mg) caplets every 4 hours, as needed, for pain.
- Do not exceed 12 caplets in 24 hours, unless a doctor approves it.
Parents and caregivers should avoid giving aspirin to children or teenagers. According to older research, aspirin may increase the risk of a child developing Reye’s syndrome. This is a rare but life threatening condition.
More recent studies also conclude that although scientists have not confirmed the association, enough evidence suggests that aspirin has a link with Reye’s syndrome.
Ibuprofen also comes in different sizes and dosages. Both generic and brand name versions are available at most pharmacies.
It is also available in infant and child formulas, typically in a liquid or chewable tablet form. Always follow dosing instructions.
Ibuprofen has a black box warning indicating that it can increase the risk of heart attack or stroke. People with high blood pressure or a history of this condition should therefore avoid ibuprofen or use it with caution.
Also, a person should talk to their doctor about taking ibuprofen if they have a history of ulcers, heartburn, or other stomach issues. People should also talk to their doctor if they are currently taking any prescription medications, such as diuretics.
Those with kidney disease, liver issues, high blood pressure, or heart disease should avoid ibuprofen.
Adults and children aged 12 and over can take ibuprofen. Below are some tips from the U.S. National Library of Medicine on how to use ibuprofen:
- Take one 200 mg caplet every 4–6 hours, as needed.
- If fever or pain does not respond to one caplet, a person can take two caplets.
- A person should not exceed six caplets in 24 hours, unless a doctor states otherwise.
- Parents and caregivers should talk to their child’s pediatrician before use, if the child is under 12 years of age.
There are two forms of naproxen: naproxen and naproxen sodium. The main difference is that the body more rapidly absorbs naproxen sodium.
Naproxen is available in most pharmacies as both generic and brand name versions. It has several dose sizes and can come in different forms.
Naproxen, like ibuprofen, has a black box warning on the label regarding heart attack, stroke, and stomach bleeding. People at risk of any of these events should not take naproxen.
A person should follow all instructions on the individual packaging labels. If a person is not sure about the proper dose, they should speak to their doctor before taking it.
People should avoid taking naproxen if they:
- are taking other OTC anti-inflammatories
- have a history of stomach issues
- have asthma
- are taking diuretics
Those with kidney, liver, or heart disease should also avoid naproxen.
It is also important that pregnant women and those who may soon become pregnant talk to their doctor before using naproxen.
The U.S. National Library of Medicine provide the following tips for taking naproxen:
- Take naproxen only as directed.
- Take the smallest effective dose only.
- Drink a full glass of water with each dose.
Based on 220 mg of naproxen sodium or 200 mg of naproxen, adults and children aged 12 years and over should take:
- one tablet every 8–12 hours, as needed
- on the first dose, two tablets within the first hour
- no more than two tablets in any 8- to 12-hour period
- no more than three tablets in 24 hours
Like all medications, NSAIDs have the potential to cause mild-to-severe side effects. For example, aspirin, ibuprofen, and naproxen can all cause minor side effects, including:
- stomach pain
If these symptoms persist, a person should talk to a doctor and discontinue use of the medication.
People should also watch out for side effects such as:
- difficulty breathing
- swelling around the eyes, lips, tongue, face, or throat
- ringing in the ears
- an accelerated heartbeat
- hearing loss
- rapid breathing
- cold, clammy skin
- bloody vomit
- bright red blood in stools
- black or tarry stools
These symptoms require immediate medical attention.
Also, the Food and Drug Administration (FDA) have recently strengthened an existing black box warning for both ibuprofen and naproxen.
The black box warning indicates that both ibuprofen and naproxen can increase the risk of heart attack or stroke in people who take them. The risk may increase the longer someone uses them. For this reason, people at risk of heart attack or stroke should avoid these medications.
OTC anti-inflammatories can also cause gastrointestinal issues. These issues include ulcers, inflammation, pain, and perforation of the intestines or stomach. People with a history of stomach issues, including ulcers and heartburn, should therefore talk to their doctor before taking any of these medications.
A person should see a doctor if they experience any symptoms of an allergic reaction, any serious side effects, or any worsening side effects from taking any OTC anti-inflammatory.
A person should seek emergency medical attention if they experience difficulty breathing or notice any blood in the vomit or stool.
If a person is allergic to any NSAID, has other health issues, or is taking prescription medications, they should talk to their doctor before taking any NSAID.
NSAIDs are anti-inflammatory medications that are available in lower dosages over the counter.
People should use OTC anti-inflammatories with caution, as there is a potential for negative health effects. All NSAIDs have a risk of stomach bleeding, for example, while ibuprofen and naproxen can raise the risk of heart attack and stroke.
Most people taking OTC anti-inflammatories will not experience side effects if they use the medications sparingly and always follow the dosing instructions on the packaging.
If a person has any doubts about taking NSAIDs, they should talk to their doctor.